Dental pre-op?

[IMGASMD]

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1. Good idea for all pregnant women in 1st trimester.
2. Diabetics tend to have higher dental issues.
3. How many surgery procedures these days require a dental check off?
4. An unhealthy mouth can lead to big problems for many people with blood diseases.
5. The whole cardiac -- oral health connection thing.
6. etc.

I take problem with number 3? Any of your patients ever had a dental pre-op? I will admit I have never seen a dental preop in chart.....

 

[deleted87051]

I take problem with number 3? Any of your patients ever had a dental pre-op? I will admit I have never seen a dental preop in chart.....

Occasionally patients will come to the OR for extraction of rotten teeth+-debridement before they get their valve or joint replacement.

 

[DrZzZz]

Occasionally patients will come to the OR for extraction of rotten teeth+-debridement before they get their valve or joint replacement.

We do a lot of these cases. Any idea why they can't just coordinate it and pull the teeth right before the valve surgery (as opposed to having to come in and get an extra anesthetic with their critically stenotic valve)?

 

[Robotic Wis-Hipple]

We do a lot of these cases. Any idea why they can't just coordinate it and pull the teeth right before the valve surgery (as opposed to having to come in and get an extra anesthetic with their critically stenotic valve)?

Bacteremia

 

[DrZzZz]

Bacteremia

That's what I assumed. Is there actual evidence supporting that statement or just theoretical?

 

[Robotic Wis-Hipple]

That's what I assumed. Is there actual evidence supporting that statement or just theoretical?

That is an interesting question. Last I looked, the answer was not really. Though the question asked was is there a difference in IE rates in pts who undergo prosthetic valve implantations with vs without prior teeth extractions and the difference was not statistically significant iirc.

But if the thought is a low level of bacteremia after brushing or associated with generally poor dental care and chronic abscesses etc may increase risk of prosthetic tissue seeding it follows that blood levels would be highest during the actual extractions.